Network meta-analysis comparing the clinical outcomes and safety of robotic, laparoscopic, and transanal total rectal mesenteric resection for rectal cancer / 中华胃肠外科杂志

Objective: To methodically assess the clinical effectiveness and safety of robot-assisted total rectal mesenteric resection (RTME), laparoscopic-assisted total rectal mesenteric resection (laTME), and transanal total rectal mesenteric resection (taTME). Methods: A computer search was conducted on PubMed, Embase, Cochrane Library, and Ovid databases to identify English-language reports published between January 2017 and January 2022 that compared the clinical efficacy of the three surgical procedures of RTME, laTME, and taTME. The quality of the studies was evaluated using the NOS and JADAD scales for retrospective cohort studies and randomized controlled trials, respectively. Direct meta-analysis and reticulated meta-analysis were performed using Review Manager software and R software, respectively. Results: Twenty-nine publications comprising 8,339 patients with rectal cancer were ultimately included. The direct meta-analysis indicated that the length of hospital stay was longer after RTME than after taTME, whereas according to the reticulated meta-analysis the length of hospital stay was shorter after taTME than after laTME (MD=-0.86, 95%CI: -1.70 to -0.096, P=0.036). Moreover, the incidence of anastomotic leak was lower after taTME than after RTME (OR=0.60, 95%CI: 0.39 to 0.91, P=0.018). The incidence of intestinal obstruction was also lower after taTME than after RTME (OR=0.55, 95%CI: 0.31 to 0.94, P=0.037). All of these differences were statistically significant (all P<0.05). There were no statistically significant differences between the three surgical procedures regarding the number of lymph nodes cleared, length of the inferior rectal margin, or rate of positive circumferential margins (all P>0.05). An inconsistency test using nodal analysis revealed no statistically significant differences between the results of direct and indirect comparisons of the six outcome indicators (all P>0.05). Furthermore, we detected no significant overall inconsistency between direct and indirect evidence. Conclusion: taTME has advantages over RTME and laTME, in terms of radical and surgical short-term outcomes in patients with rectal cancer.

Correlation study of risk of tumble with gradings in patients with leukoaraiosis / 中华神经医学杂志

Objective To explore the correlation of risk of tumble with gradings in patients with leukoaraiosis.Methods One hundred patients with leukoaraiosis,admitted to our hospital from June 2010 to June 2012,were selected as an observation group; another 100 elderly controls accepted physical examinations in our physical examination center at the same period were also selected.All subjects from the observation group underwent head CT or MRI examination to compare the cerebral white matter.The Berg balance scale was used to evaluate the ability of balance and divided into poor balance (0-20 scores),balance (21-40 scores) and better balance (41-56 scores).Results In the observation group,the proportion of poor balance and balance patients was averagely higher than that of control group; and the ratio of better balance function was lower than the control group.About the Berg balance scale scores with less than 40,the observation group was higher than that of the control group (P＜0.05).Spearman rank correlation analysis showed a positive correlation between leukoaraiosis grading and balance dysfunction (Ts=0.790,P=0.000).Conclusion Senile leukoaraiosis patients have different degrees of balance dysfunction and the higher leukoaraiosis degrees they have,the severer of balance dysfunction they will get.

Relationship between abdominal obesity and left ventricular weight/function / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the relationship between abdominal obesity and left ventricular weight/function.</p><p><b>METHODS</b>A total of 495 patients [265 males, mean age (55 +/- 12) years] with hypertension (139), diabetes (65), metabolic syndrome (285), diabetes complicated with hypertension (11) were enrolled in this study. Visceral adipose area (VA), the subcutaneous adipose (SA), the total abdominal adipose (TA) were measured by computerized tomography (CT) and left ventricular weight and function were obtained by echocardiography. Patients were divided into three groups according to the VA (I. VA<75 cm(2), n=173, II. VA>75 and < 110 cm(2), n=153, III. VA >or= 110 cm(2), n=169).</p><p><b>RESULTS</b>Left ventricular mass (LVM) and LVM index (LVMI) increased and LVEF and E/A decreased in proportion to increasing VA. Left ventricular hypertrophy (LVH) rate was significantly higher in group II and III compared to group I and LVEF was significantly reduced in group III compared to group I and II. There are significant correlation between LVMI and VA, SA, TA as well as between LVEF and VA after adjusting gender, age and blood pressure. Logistic regression analysis showed that VA is an independent predictor for LVH.</p><p><b>CONCLUSION</b>The abdominal adipose accumulation is closely related to the left ventricular weight and function.</p>